OBJECTIVE To study anatomical features of the cavernous segment of the internal carotid artery(ICA)via the extended transsphenoid approach under endoscope.METHODS Extended transsphenoid approach was performed on 11 adult cadaver heads.The appearance features of the cavernous segment of the ICA and its vessel branches were observed under endoscope.RESULTS The cavernous segment of the ICA can be divided into 5 segments and has 3 vessel branches.The optico-carotid recess is the landmark to define the ICA and optic nerve during operation.The optico-carotid recess is located between internal carotid and optic prominences,all of them are located on the lateral wall of the sphenoid sinus.CONCLUSION The cavernous segment of the ICA is the most important anatomic structure via the extended transsphenoid approach.The cavernous segment of the ICA,branch vessels,and important nerve tissue structures can be clearly visualized under endoscope via the extended transsphenoid approach.An extended transsphenoid approach with the help of an endoscope is an optimal surgical approach for the lesions that invade the internal wall of cavernous sinus.

Objective To investigate the clinical efficacy of repairment using ear endoscope for small perfo-ration of the tympanic membrane after traditional tympanoplasty.Methods A retrospective analysis of 42 cases of repairment using ear endoscope for small perforation of the tympanic membrane after traditional tympanoplasty was investigated.Adipose tablet of earlobe to repair small perforation or perichondrium of hircus for medium perforation was used.Results The success rate after one repairment of small perforation was 82.76%(24 /29).The success rate for medium perforation was 61.54%(8 /13).9 cases received the repairment for 2 times or even more to heal the tym-panic membrane.The mean improvement of air conduct at language frequency was 20.03dB by 6 months after the successful operations (t =1.98,P <0.05)and air bone guide.The mean difference between the air conduct and bone conduct decreased as much as 19.82dB (t =1.86,P <0.05)with statistical significance.Conclusion The success rate was high to repair the perforation using ear endoscope after traditional tympanoplasty.The hearing was improved obviously and the patients were very compliant.

Objective To investigate the effect of recombinant human growth hormone (rhGH) on rat liver injury with severe acute pancreatitis.Methods Severe acute pancreatitis model was established by injection of sodium taurocholate into the pancreatobiliary duct in 40 male Sprague-Dawley rats.Rats were randomly divided into experiment group (n =20) and control group (n =20).Another 20 male SD rats injected saline served as negative control group.The experiment group were treated with subcutaneously injected rhGH for 3 days,1 U·kg-1 ·d-1.12 h and 24 h after operation,the level of ALT,AST,TNF-α,IL-1 β,SOD,MDA,endotoxin and D-lactate was detected respectively;the degree of live cell apoptosis and pathological score of pancreatic tissue were compared among these groups.Results In comparison with negative control group,the level of ALT,AST,TNF-α,IL-1β,MDA,endotoxin and D-lactate,the liver cell apoptosis index and pathological score of pancreatic tissuc were significantly higher in the control group and experiment group at 12 h and 24 h after operation (P ＜ 0.05).ALT,AST,TNF-α,endotoxin and D-lactate at 12 h and 24 h were significantly lower in the experiment group (P ＜ 0.05).MDA level significantly declined at 12 h and 24 h after operation in experiment group(P ＜ 0.05).Liver cell apoptosis index of the control group was higher than experiment group (P =0.003).Conclusion rhGH pretreatment relieves liver injury in rat with severe acute pancreatitis.

In order to compete the antiviral effects of the host cell in the process of infection, ORFV(known as Orf virus) relies on a series of functional genes developed through long-term population evolution, such as interferon resistance genes, Bcl-2 protein genes and cell cycle inhibitor gene and so on, with these weapons this virus is able to effectively counteract immune clearance and immune regulation from a host cell. Concurrently, ORFV also focuses on exploiting signal transduction pathways of the ubiquitin-proteasome system(UPS), circumvents the intracellular signal transduction and CD8+ T activation, for shielding virus particles towards maturation and releasing outside. This review introduced inner link between the UPS of host cell and intervention mechanism by virus, and analyzed the key roles of certains components in UPS, these all together showed the evolution tendency of ORFV that was involved in the designing of inhibition to immune response and for intracellular immune escape upon the selection pressure in host cell infected.
Animals ; Ecthyma, Contagious ; enzymology ; virology ; Host-Pathogen Interactions ; Humans ; Orf virus ; genetics ; physiology ; Proteasome Endopeptidase Complex ; metabolism ; Ubiquitin ; metabolism

Contagious ecthyma (also known as orf) is an acute skin zoonosis caused by orf virus (ORFV), which affects sheep, goats and humans. As one of the typical species of the Parapoxvirus genus of the Poxviridae family, orf virus has distinctive and unique characteristics of these species. A range of immuno-modulatory/pathogenesis -related genes acquired by virus that function is to limit (at least transiently) the effectiveness of host immunity during its evolution. This review is aimed to describe the latest progress on the molecular characteristics of ORFV, and upon which we analyzed molecular mechanism of the immune escape designed and a set of strategies developed for ORFV to effective against immune clearance of the host. Known as an essential component in evolutionary system, host is regulated by ORFV for using in population evolution. By the ORFV evolutional immune regulation components and its effect approach, we can understand the viral biological characteristics of ORFV, and it is helpful for us to further study the counter-measures of this disease.
Animals ; Ecthyma, Contagious ; immunology ; virology ; Gene Expression Regulation, Viral ; Immune Evasion ; Orf virus ; genetics ; immunology ; Viral Proteins ; genetics ; immunology

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy

OBJECTIVETo establish a domestic database of Enterobacteria cloacae (E. cloacae), and improve the identification efficiency using peptide mass fingerprinting.

METHODSPeptide mass fingerprinting was used for the identification and subtyping of E. cloacae. Eighty-seven strains, identified based on hsp60 genotyping, were used to construct and evaluate a new reference database.

RESULTSCompared with the original reference database, the identification efficiency and accuracy of the new reference database was greatly improved at the species level. The first super reference database for E. cloacae identification was also constructed and evaluated. Based on the super reference database and the main spectra projection dendrogram, E. cloacae strains were divided into two clades.

CONCLUSIONPeptide mass fingerprinting is a powerful method to identify and subtype E. cloacae, and the use of this method will allow us to obtain more information to understand the heterogeneous organism E. cloacae.

BACKGROUND: Treatment of coronary bifurcation lesions remains challenging; a simple strategy has been preferred as of late, but the disadvantage is ostium stenosis or even occlusion of the side branch (SB). Only a few single-center studies investigating the combination of a drug-eluting stent in the main branch followed by a drug-eluting balloon in the SB have been reported. This prospective, multicenter, randomized study aimed to investigate the safety and efficacy of a paclitaxel-eluting balloon (PEB) compared with regular balloon angioplasty (BA) in the treatment of non-left main coronary artery bifurcation lesions. METHODS: Between December 2014 and November 2015, a total of 222 consecutive patients with bifurcation lesions were enrolled in this study at ten Chinese centers. Patients were randomly allocated at a 1:1 ratio to a PEB group (n = 113) and a BA group (n = 109). The primary efficacy endpoint was angiographic target lesion stenosis at 9 months. Secondary efficacy and safety endpoints included target lesion revascularization, target vessel revascularization, target lesion failure, major adverse cardiac and cerebral events (MACCEs), all-cause death, cardiac death, non-fatal myocardial infarction, and thrombosis in target lesions. The main analyses performed in this clinical trial included case shedding analysis, base-value equilibrium analysis, effectiveness analysis, and safety analysis. SAS version 9.4 was used for the statistical analyses. RESULTS: At the 9-month angiographic follow-up, the difference in the primary efficacy endpoint of target lesion stenosis between the PEB (28.7% ± 18.7%) and BA groups (40.0% ± 19.0%) was -11.3% (95% confidence interval: -16.3% to -6.3%, Psuperiority <0.0001) in the intention-to-treat analysis, and similar results were recorded in the per-protocol analysis, demonstrating the superiority of PEB to BA. Late lumen loss was significantly lower in the PEB group than in the BA group (-0.06 ± 0.32 vs. 0.18 ± 0.34 mm, P < 0.0001). For intention-to-treat, there were no significant differences between PEB and BA in the 9-month percentages of MACCEs (0.9% vs. 3.7%, P = 0.16) or non-fatal myocardial infarctions (0 vs. 0.9%, P = 0.49). There were no clinical events of target lesion revascularization, target vessel revascularization, target lesion failure, all-cause death, cardiac death or target lesion thrombosis in either group. CONCLUSIONS: In de novo non-left main coronary artery bifurcations treated with provisional T stenting, SB dilation with the PEB group demonstrated better angiographic results than treatment with regular BA at the 9-month follow-up in terms of reduced target lesion stenosis. TRIAL REGISTRATION ClinicalTrials.gov, NCT02325817; https://clinicaltrials.gov.

Objective:To evaluate the clinical efficacy and safety of Longmu Zhuanggu granule for the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency. Method:This multicenter stratified， block-randomized， double-blind， double-dummy， positive drug （pidotimod granule） parallel controlled， and non-inferiority trail intended to included 240 children patients and divided them into the experimental group （n=120） and the control group （n=120） at the ratio of 1∶1. Patients in both groups were treated for eight successive weeks and followed up for 12 months. The cure rates， numbers of respiratory infections， average courses of disease， curative effects of traditional Chinese medicine （TCM） syndrome， curative effects of individual symptoms， curative effects of immune indexes， and safety indexes between the two groups were observed and compared. Result:A total of 237 subjects were collected from 10 research centers， including 119 cases in the control group and 118 in the experimental group. There were 236 cases enrolled into the full analysis set （FAS）， 210 into the per-protocol set （PPS）， and 236 into the safety set （SS）. The baseline data of the two groups were not significantly different from each other， indicating that they were comparable. The cure rates of the experimental group and control group were 75.21% （88/117） and 73.95%（88/119）， respectively， with the 95% confidence interval （CI） of difference between the two groups being 1.26% （-9.85%，12.37%） for FAS and 3.81% （-6.28%，13.90%） for PPS. The 95% CI fell within the 10% non-inferiority margin， implying that non-infertility test of the cure rate in the treatment of endpoint disease was valid， and the conclusions of FAS and PPS analysis were consistent. There was no significant difference in the number or course of upper respiratory infection， bronchitis， and pneumonia. The difference in curative effects of TCM syndrome between the two groups after four weeks of treatment was not remarkable. After eight weeks of treatment， the total effective rate of the experimental group was 84.62%（99/117）， statistically higher than 78.15%（93/119） of the control group（χ²=-3.26，P<0.05）. There were no significant differences in the disappearance rates of individual symptoms between the two groups after four weeks of treatment. After eight weeks of treatment， the experimental group and control group exhibited the disappearance rates of 67.50%（54/80） and 47.37%（36/76） for shortness of breath and laziness to speak， 75.00%（54/72） and 53.33%（40/75） for poor appetite， 54.55%（60/110） and 37.84%（42/111） for hyperhidrosis， respectively， with obviously better outcomes observed in the experimental group （P<0.05，P<0.01）. The inter-group comparison revealed significant differences in immune indexes after eight weeks of treatment. As demonstrated by comparison with the situations before treatment， IgA， IgG， IgM， and CD4 did not change significantly after treatment. Except for CD8 in the experimental group (P<0.05), there was no significant difference in other immune indexes before and after treatment There was no significant difference in the incidence of adverse reactions. Conclusion:Longmu Zhuanggu granule is not inferior to pidomod granule in the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency， and it exhibits good safety， implying its promising clinical application value.